You are here

Article Text

Article menu

Download PDFPDF

Review
Clinical aspects of incorporating cord clamping into stabilisation of preterm infants
  1. Ronny Knol1,
  2. Emma Brouwer2,
  3. Alex S N Vernooij3,
  4. Frans J C M Klumper4,
  5. Philip DeKoninck5,6,
  6. Stuart B Hooper6,
  7. Arjan B te Pas2
  1. 1 Division of Neonatology, Department of Paediatrics, Erasmus University Medical Centre, Rotterdam, Zuid-Holland, The Netherlands
  2. 2 Division of Neonatology, Department of Paediatrics, Leiden University Medical Centre, Leiden, The Netherlands
  3. 3 Department of Medical Engineering, Leiden University Medical Centre, Leiden, The Netherlands
  4. 4 Department of Obstetrics, Leids Universitair Medisch Centrum, Leiden, Zuid-Holland, The Netherlands
  5. 5 Department of Obstetrics and Gynaecology, Erasmus University Medical Centre, Rotterdam, The Netherlands
  6. 6 The Ritchie Centre, Hudson Institute of Medical Research, Monash University, Clayton, Victoria, Australia
  1. Correspondence to Dr Ronny Knol, Division of Neonatology, Department of Paediatrics, Erasmus University Medical Centre, PO Box 2060, Rotterdam 3000 CB, The Netherlands; r.knol{at}erasmusmc.nl

Abstract

Fetal to neonatal transition is characterised by major pulmonary and haemodynamic changes occurring in a short period of time. In the international neonatal resuscitation guidelines, comprehensive recommendations are available on supporting pulmonary transition and delaying clamping of the cord in preterm infants. Recent experimental studies demonstrated that the pulmonary and haemodynamic transition are intimately linked, could influence each other and that the timing of umbilical cord clamping should be incorporated into the respiratory stabilisation. We reviewed the current knowledge on how to incorporate cord clamping into stabilisation of preterm infants and the physiological-based cord clamping (PBCC) approach, with the infant’s transitional status as key determinant of timing of cord clamping. This approach could result in optimal timing of cord clamping and has the potential to reduce major morbidities and mortality in preterm infants.

  • neonatology
  • physiology
  • resuscitation

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/archdischild-2018-314947

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Contributors RK wrote the first draft of the manuscript. All authors contributed by modifying and editing the manuscript. RK and ABtP processed the final remarks and accounted for the final version of the manuscript.

    • Funding ABtP is recipient of a Netherlands Organisation for Scientific Research (NWO) innovational research incentives scheme (VIDI 91716428).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    Linked Articles

    • Fantoms
      Highlights from this issue
      Ben Stenson
      Archives of Disease in Childhood - Fetal and Neonatal Edition 2018; 103 F397-F397 Published Online First: 16 Aug 2018. doi: 10.1136/archdischild-2018-315971